Two Months Before the 2018 Hurricane Season Begins, Health Centers in Puerto Rico and the U.S. Virgin Islands Still Face Serious Threats.

Two Months Before the 2018 Hurricane Season Begins, Health Centers in
Puerto Rico and the U.S. Virgin Islands Still Face Serious Threats

WASHINGTON, DC and NEW YORK, NY (April 4, 2018) – Six months after Hurricanes Irma and Maria pummeled Puerto Rico and the U.S. Virgin Islands (USVI), the regions’ twenty-three community health centers continue to play a crucial role in responding to the catastrophe, providing direct care and essential community-based public health services. Yet, a new report by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University’s Milken Institute School of Public Health (Milken Institute SPH), based on a comprehensive survey, finds that health center recovery is uneven, and that while all health centers are open, many are still operating under hardship conditions.

“The community health centers in Puerto Rico and the U.S. Virgin Islands have done a remarkable job of rebuilding and finding ways to remain in operation under challenging conditions,” said Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy and founder of the Geiger Gibson Program in Community Health Policy at the Milken Institute SPH. “However, the centers, as well as their employees and the populations they serve, remain vulnerable as the next hurricane season approaches for a number of reasons. Limited health care access, hazardous living conditions, and heightened risk of infectious disease and mental health concerns put both providers and patients at greater risk. A recent report suggesting that the number of suicides in Puerto Rico has increased significantly merits serious attention.”

In 2016, the health centers in Puerto Rico the U.S. Virgin Islands served nearly 370,000 people. Compared to community health centers in the 50 states and the District of Columbia, the centers in these territories serve higher percentages of patients with incomes under the federal poverty level and those insured through Medicaid.

Presently, the 23 health center organizations in the region operate 99 sites, with 93 in Puerto Rico and 6 in the USVI. At the time of the survey, 91 percent of health center sites were open and operating at full capacity and with a full complement of services. The remaining nine percent were open, but at partial capacity or with a more limited range of services. Of note, all community health centers reported that general primary care services, medical records, and community outreach services are fully restored at all sites that provided these services before the hurricanes. But more than four in ten health centers reported that specialty care services, emergency department services, and night and weekend hours were available at only some sites that provided them prior to the hurricanes. Nearly two-thirds of health centers report needing repair or replacement of their buildings, and nearly half report needing telephone and internet repair or replacement. While the majority of health centers reported that they were able to maintain staffing levels and did not find it necessary to reduce services due to staffing constraints, both recruitment and retention are challenging; physicians, pharmacy staff, substance abuse staff, and mental health staff were reported to be the most difficult positions to recruit for and retain. Health centers also reported the top challenges facing their staff: 70 percent reported workers losing homes and 57 percent reported transportation problems and road conditions as top-three challenges. More than 80 percent of health centers expect that their organization will be restored to full capacity in less than one year.

“The community health centers in Puerto Rico and the U.S. Virgin Islands are a crucial part of the health care system and have demonstrated extraordinary resilience, both in the immediate aftermath and the now six months following Hurricanes Irma and Maria,” said Feygele Jacobs, DrPH, President and CEO of the RCHN Community Health Foundation, whose ongoing gift supports the Geiger Gibson Program. “With the next hurricane season on the horizon, it’s essential that health centers receive the support necessary to aid staff, address staffing and human resource needs, and fully rebuild.”

About the Geiger Gibson Program in Community Health Policy:The Geiger Gibson Program in Community Health Policy is a special initiative of Milken Institute School of Public Health at the George Washington University. Housed in the Department of Health Policy and Management, and named after Drs. H. Jack Geiger and Count Gibson, pioneers in community health practice and tireless advocates for civil and human rights, the program aims to develop the next generation of community health leaders by offering education, research and training in community health practice and leadership. The program’s research and educational activities seek to advance the education and policy development in the fields of health centers, primary health care for medically underserved populations, and health disparities reduction. The Geiger Gibson Program also offers a Fellows program, a health policy elective for medical residents, scholarship opportunities, an annual Distinguished Visitorship and more.

About the RCHN Community Health Foundation:The RCHN Community Health Foundation is a not-for-profit foundation established to support community health centers through strategic investment, outreach, education, and cutting-edge health policy research. The only foundation in the U.S. dedicated solely to community health centers, RCHN CHF builds on a long-standing commitment to providing accessible, high-quality, community-based healthcare services for underserved and medically vulnerable populations. The Foundation’s gift to the Geiger Gibson program supports health center research and scholarship.

About Milken Institute School of Public Health at the George Washington University:Established in July 1997 as the School of Public Health and Health Services, Milken Institute School of Public Health is the only school of public health in the nation’s capital. Today, more than 1,900 students from 54 U.S. states and territories and more than 50 countries pursue undergraduate, graduate and doctoral-level degrees in public health. The school also offers an online Master of Public Health, MPH@GW, and an online Executive Master of Health Administration, MHA@GW, which allow students to pursue their degree from anywhere in the world.